Diagnostic markers of yersiniosis in patients with inflammatory bowel diseases

A. Sorokin, M. V. Solovyov, K. P. Raevsky, E. Voskresenskaya, G. L. Kokorina, E. Bogumilchik
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Abstract

Relevance. This study is related to the study of the etiology, pathogenesis and clinic of inflammatory bowel diseases (IBD). In a number of patients with IBD who are refractory to anti-inflammatory/immunosuppressive therapy, there are signs of current or transferred yersiniosis infection, not diagnosed by routine methods.Aim. According to the scientific literature and the results of our own research, to identify the presence and assess the nature of the influence of yersinia on the occurrence and development of IBD.Materials Methods. In our study, we conducted a bacteriological examination of feces by polymerase chain reaction (PCR) in patients with a diagnosis of IBD (UC and CD) in the acute phase (MMDAI ≥ 4 points for UC and Best index ≥ 150 points for CD), as well as immunological diagnostics using enzyme immunoassay (IFA) in the version of line-blotting (IB). Using the results obtained, clinical and instrumental semiotics were evaluated in subgroups of individuals suffering from IBD with confirmed yersiniosis ("IBD+ IER+") and without it ("IBC+ IER–"). We also assessed the role of intestinal infection by determining the effectiveness of initial antibacterial therapy in the treatment of exacerbation of IBD.Results. A significant part (in the case of our sample – 45%) of patients with IBD, when examined by high-tech methods, demonstrate the presence of markers of a transferred or current yersiniosis infection. Its role in the initiation and development of autoimmune intestinal inflammatory process requires further clarification.Conclusions. In 45% of patients with IBD, high-precision examination reveals markers of transferred or current yersiniosis infection. Routine clinical methods for the diagnosis of yersiniosis have low sensitivity and do not allow us to convincingly assess the role of this bacterial agent as a trigger factor for the onset or recurrence of IBD. There is a tendency for greater manifestation in the debut of IBD in patients with markers of systemic yersiniosis. The fact of improvement against the background of empirical antibacterial therapy in 24% of patients with IBD, achievement of early clinical remission in 57% of patients receiving antibiotic therapy, indicates a significant role of bacterial enterocolopathogens in the genesis of chronic intestinal inflammation in a number of patients.
炎症性肠病患者耶尔森菌病的诊断标志物
的相关性。本研究涉及炎症性肠病(IBD)的病因、发病机制及临床研究。在一些对抗炎/免疫抑制治疗难治性的IBD患者中,有当前或转移的耶尔森菌病感染的迹象,不能通过常规方法诊断。根据科学文献和我们自己的研究结果,确定耶尔森菌的存在并评估其性质对IBD发生和发展的影响。材料的方法。在我们的研究中,我们对诊断为IBD (UC和CD)的急性期患者(UC≥4分,CD≥150分)的粪便进行了聚合酶链反应(PCR)的细菌学检查,并使用线印迹(IB)版本的酶免疫测定(IFA)进行了免疫学诊断。利用获得的结果,对确诊为耶尔森菌病(“IBD+ IER+”)和未确诊为耶尔森菌病(“IBC+ IER -”)的IBD患者亚组进行临床和工具符号学评估。我们还通过确定初始抗菌治疗在ibd恶化治疗中的有效性来评估肠道感染的作用。在我们的样本中,有很大一部分IBD患者(45%)在用高科技方法检查时,显示出转移或当前耶尔森菌病感染的标志物的存在。它在自身免疫性肠道炎症过程的发生和发展中的作用有待进一步阐明。在45%的IBD患者中,高精度检查显示转移性或当前耶尔森菌病感染的标志物。诊断耶尔森菌病的常规临床方法敏感性低,不能让我们令人信服地评估这种细菌制剂作为IBD发病或复发的触发因素的作用。在有系统性耶尔森菌病标志物的IBD患者中,有更大表现的趋势。24%的IBD患者在经年性抗菌药物治疗的背景下病情有所改善,57%的接受抗生素治疗的患者实现了早期临床缓解,这一事实表明细菌性肠道病原菌在许多患者慢性肠道炎症的发生中发挥了重要作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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